Organization
GENERAL FAMILY DENTISTRY
Active
Parent organization
COSMETIC AND RESTORATIVE GENERAL DENTISTRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
COSMETIC AND RESTORATIVE GENERAL DENTISTRY
Authorized official
DR. JAMES A TYRER III DMD (DENTIST/OWNER)
(706) 882-0094
Entity
Organization
Contact information
Practice address
108 W POINT ST, ROANOKE, AL 36274-1686
(334) 863-4514
(334) 863-4470
Mailing address
108 W POINT ST, ROANOKE, AL 36274-1686
(334) 863-4514
(334) 863-4470
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5533
AL
Other
Enumeration date
11/06/2008
Last updated
04/28/2009
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